It is important to have a schedule of routine cleaning disinfection tasks that

are accomplished consistently.

These task should occur on a regular basis.

For example, daily or weekly, as directed by facility policy.

Consistently completing these routine tasks will help to minimize the build up

of dirt, soil, and pathogens and aid in maintaining a sanitary environment.

Take a moment to review these recommendations.

Terminal room cleaning disinfection occurs following the discharge or

transfer of a resident.

All surfaces that came in contact with the prior resident or

that may have been contaminated during prior resident care, must be disinfected.

This includes, not only high touch surfaces, but

also mattresses, headboard, furniture, and privacy curtains.

Cleaning disinfection is not an exclusive activity of environmental services staff.

Nurses and other health care providers also play a role in disinfection.

Especially shared resident equipment or

devices Like IV pumps, BP cuffs, and blood glucose meters.

Assigning responsibility will clarify which category of worker

has ownership of disinfecting certain equipment and surfaces.

Consider forming an interdisciplinary team to develop a grid

that indicates which items should be disinfected, the disinfectant to be used,

how often it should occur, and category of worker responsible.

Ensuring that clean disinfection practices are complete,

thorough, and effective presents special challenges for long term care facilities.

Multiple studies have shown that environmental services staff wipe only

about 32% of surfaces targeted for cleaning disinfection.

Failure to thoroughly disinfect a room allows for reservoir of pathogens to

accumulate and be transmitted to other residents and future room occupants.

A resident moving into a room that has not been thoroughly disinfected has 20

to 200% increased risk of acquiring a pathogen from the prior room

occupant compared to a resident moving into a thoroughly disinfected room.

The environmental services department is responsible for

monitoring the effectiveness of cleaning disinfection.

Environmental rounds and regular visual inspection can detect obvious problems,

but are insufficient for

determining if effective cleaning disinfection has taken place.

For that reason, environmental monitoring tools are being incorporated into

quality improvement programs to improve the thoroughness of cleaning disinfection.

The first step in quality monitoring is to incorporate a checklist or

other audit tools.

There are two additional methods to determine if effective cleaning

disinfection has taken place.

Detection of residual soiling using adenosine triphosphate, ATP,

bioluminescence, and florescent making of hard surfaces.

Regardless of the method chosen to monitor cleaning disinfection practices,

it is important that front line environmental surfaces staff are provided

with monitoring results and additional education, if needed.

This has been shown to increase motivation, engagement, and

improve practices.

Let's tune in as Charlie wraps up his orientation session with Sarah.

>> Do you fear you're not cleaning enough?

Do you know if you're even cleaning with the right disinfectant?

Well, never fear your job again.

By combining the triple threat cleaning method with the correct cleaning solution,

you'll be a whiz in no time.

Environmental service workers across the country

rely on a solution of quaternary ammonium compound for most of their cleaning needs.

But sometimes, residents have infections that require something stronger.

Then they turn to the big guns.

Product plus practice equals perfection.

>> So I'm beginning to get the hang of the rules around here.

Let me see if I've got it all covered.

By combining the correct application and use of the product with thorough and

complete practice, we get the third P, perfection.

>> Now you're cooking with gas, Sarah.

Almost there, just one last rule of thumb.

Actually, that's the perfect lead in, speaking of thumbs,

I see yours are in a pair of gloves, and that's great.

Now, let's get you in a gown.

>> But we're cleaning with bleach, I thought bleach is the ultimate clean.

>> It is, but there is no reason not to take precautions for yourself and

the other residents, when someone is in isolation precautions.

Isolation precautions, can you remind me what that is again?

>> Of course, you may see a sign like this.

Or these.

They tell us that a person has a really bad germ.

My MRSA, VRE, or C Difficile that easily

transmitted by healthcare workers like you, me, and everyone else.

So when a patient is on isolation precautions,

it means that everyone entering the room, including you,

needs to wear the appropriate personal protection equipment.

For instance, the resident in this room that you are cleaning has C Difficile,

so you should be wearing gowns and gloves when cleaning this room.

>> Isn't that kind of bulky?

>> I just had a cheeseburger, so let's not talk about bulk.

Just kidding.

In all seriousness, we wear these gowns and gloves to protect our clothes, and

skin from being contaminated.

And protect the health and safety of our residents here at Sunnyside

by not becoming a source of cross-transmission.

You're right, Charlie.

I'm really glad that you stopped in here today.

It definitely made my first day make a lot more sense.

>> Any time.

And remember, we're not just a maid service.

We are a part of the infection control team.

By doing our part and

cleaning well, we keep our residents healthy, safe and happy.

Welcome aboard, Sarah.

Keep rocking those three P's.

[MUSIC]

4.3 Monitoring the effectiveness of cleaning

Infection Prevention in Nursing Homes

Conoce a los instructores